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Re: Started Geodon, off Zyprexa--scott Emme

Posted by SLS on October 3, 2001, at 13:12:04

In reply to Re: Started Geodon, off Zyprexa--scott SLS, posted by Emme on October 3, 2001, at 8:24:35

Hi Emme.

> Yes, sorry to spoil your record. Glad you've been able to tolerate the lamictal well. I see so many positive posts about it. I increased the Lamictal by 12.5 mg/week. I got the rash while I was at 75 mg - just when good things were starting to happen.

I am so frustrated for you. What dosage did you start with? You aren't taking Depakote, are you? What did the rash look like?

> I've been trying other ACs for the time being. Currently I'm on Gabitril.

I'll be very interested to see how things turn out for you. Gabitril is on my list of things to try.

> Am I bipolar? My doctor certainly thinks so. It's been hard for me to believe the diagnosis because I've never really been clearly hypomanic and definitely never manic. My depression has been different at different times, sometimes accompanied by lots of anxiety, sometimes by awful fatigue, and the symptoms of depression with lots of anxiety are pretty similar to the features of a mixed state. There have been times when I definitely seemed to be cycling up and down on the time scale of a week or two, except that the "highs" never really popped up into hypomanic. My doctor says that loss of efficacy with various antidepressants is another indication. So she thinks that although no one symptom is conclusive by itself, taken together they suggest a bipolar spectrum disorder. I know the BPII diagnosis gets thrown around a lot these days. But I also trust that my doctor has a good clinical sense, and so I am willing to try the bipolar treatments.

> I assume you have been diagnosed bipolar also? How do you describe your mood disorder?

I have bipolar disorder, but it doesn't fit well into either bipolar I or bipolar II. I have been in a constant state of depression for over 20 years. It probably started around age 10, but became severe rather suddenly at age 17. I have little or no physical or mental energy, am slow-thinking, have poor concentration and memory, have no motivation to do get up out of a chair, and I experience no enjoyment (anhedonia). This state has been uninterrupted except for one 6 month period resulting from a combination of antidepressants (Parnate + desipramine), and several 3-day "blips" during various antidepressant trials.

I think the identity of the bipolar spectrum is still evolving. I really don't feel competent to comment on your doctor's diagnosis, but it seems very reasonable to me. Your history sounds very similar to mine. The only thing missing is a few drug-induced manic episodes.

My depressive state has changed over time. In the beginning, it included some pretty heavy-duty social anxiety - actually, social phobia. I would literally become physically immobilized with anxiety at parties in high school. I experienced depressed mood with negative thoughts. Everything seemed dark and gloomy. For two years, I displayed a regular weekly cycle, but my mood (I hate using that word) during the upper phase of the cycle barely reached normalcy. I was never hypomanic or manic. I was able to ace my college courses for the first two years. Although I had difficulty reading more than a few pages at a time, I really didn't pay much attention to it. I thought I was just lazy. Fortunately, reading something once was enough. I used to look forward to taking exams. They were fun. I loved physics and biology especially. Didn't care much for calculus though. The class schedule interfered with my sex-life. Anyway by the beginning of my junior year, I couldn't read or remember a damned thing. Organic chemistry did me in. Eventually, the nature of my depression became more anergic and vegetative and less melancholic with much reduced anxiety. This trend is not so unusual as one ages, but it is remarkable that this occurred so early with me. This phenomenon of a changing presentation of depression is such that very often, elderly folks are misdiagnosed as having an organic (I don't like this word either) dementia. The term "pseudodementia" has sometimes been used to describe this.

Oh, but I babble...

- Scott




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